Health

Bill Gates' Latest Challenge: Polio

Bill Gate's eureka moment came in June 2009 in an underground conference room at the World Health Organization's headquarters in Geneva. After a decade of giving away millions to eradicate polio, the billionaire philanthropist was being briefed on hours-old data showing how two doses of a new polio vaccine protected 37 percent more children than conventional ones.

The immunization, which protects against multiple strains, promised to speed the effort to wipe out the crippling killer that remains a scourge in developing nations. Several months later, Gates pledged an additional $285 million toward eradication of the malady.

Fast forward to early November, when Gates again stepped into the fight against polio. This time his charitable foundation helped broker a deal that will allow the UN to buy those new vaccines more cheaply. The Microsoft (MSFT) co-founder met with GlaxoSmithKline (GSK) Chief Executive Officer Andrew Witty in New York this month as part of talks that resulted in five international suppliers—GlaxoSmithKline, Indonesia's Bio Farma, Sanofi-Aventis (SNY), Novartis (NVS), and New Delhi-based Panacea Biotec—agreeing to steep cuts in polio vaccine prices.

Under the deal the UN Children's Fund, known as Unicef, will pay a weighted-average price of about 13 cents apiece for the 2.4 billion doses it plans to buy in 2011 and 2012, down from 14.5 cents. The price reduction reverses a decade-long trend of increases, according to Unicef. "The foundation can sometimes be a catalyst to bring parties to the table, and we saw that with Unicef and the manufacturers," Gates said in an e-mail. "The outcome was greater certainty and lower costs."

About 40 percent of Unicef's order will be for the new vaccine, which is bivalent, meaning it works against two types of polio. "We were all enthusiastic about the promise of bivalent to help us reach eradication, and to reach it sooner," Gates said in the e-mail. "We knew it had a good chance at eliminating the ping-pong effect we were seeing in taking on the different types of polio outbreaks."

The $60 million saved by the price-cuts will allow Unicef to buy up to an additional 400 million doses, says Bruce Aylward, head of WHO's polio program. "We have a real opportunity to give it our best shot to finish this with the new vaccines," he says. "The manufacturers are playing ball."

Polio, an acute viral disease, paralyzed millions of people worldwide in the 20th century. At the height of the most extensive polio outbreak ever in 1952, almost 60,000 cases with over 3,000 deaths reported in the U.S. alone. Polio was eliminated from the Western hemisphere after vaccines became widely available in the mid-1950s. Yet before the Global Polio Eradication Initiative began in 1988, the disease still paralyzed at least 350,000 children in more than 125 countries annually. Although outbreaks have been dropping fast in recent years, the malady still struck in 23 countries last year. India had the most cases.

Progress is being made: 85 vaccination campaigns in 2009 across India, Nigeria, Pakistan, and Afghanistan slashed the number of cases in those nations to 180 so far this year, from 1,051 the same time last year. Behind the success: the bivalent vaccine, first used commercially last December, in Afghanistan. Two doses of the new medicine, given as drops on the tongue, gave 86 percent of children protective antibodies against the most virulent kind of polio (no vaccine is 100 percent effective), according to a study in India. In comparison, a double dose of conventional vaccine protected 63 percent of kids from Type 1 polio.

The Seattle-based Bill & Melinda Gates Foundation has provided more than $1 billion for polio programs during the past decade, making it the biggest donor to a global three-year, $2.6 billion plan to root out the last vestiges of the disease by 2013. It would be the first viral illness in humans to be declared eradicated since smallpox in 1980. Nonetheless, the program faces an $810 million funding gap. "It's going to be expensive to travel the last mile toward eradication," said Jeff Raikes, the foundation's CEO, in September. "But it will be exponentially more expensive if we don't reach the end of the road, because we'd have to keep on treating thousands of children paralyzed each year indefinitely."